最近1年間の裂孔原性網膜剥離244眼の治療成績

One-year review of surgery in 244 cases of rhegmatogenous retinal detachment

　1989年の1年間に入院手術を行った裂孔原性網膜剥離233例244眼の手術内容と成績を示した。初回手術には，scleral buckling法を82％に，硝子体手術を9％に，ガス注入を9％に行った。再手術では硝子体手術が45％を占め，全手術ではscleral buckling法75％，硝子体手術16％，ガス注入9％であった。退院時および術後6か月の網膜復位率はともに97％であった。未復位例6眼の原因は，黄斑円孔，深部裂孔による裂孔閉塞困難例，増殖性硝子体網膜症の発生であった。

　裂孔原性網膜剥離の手術には，基本的にはscle—ral buckling法を用いることで良好な成績が得られ，本法の有用性は高いことが示されたが，一方過去の当科の報告と比べて復位率は2％上昇し，それには硝子体手術が貢献していた。

We treated 244 eyes in 233 cases of rhegmato-genous retinal detachment during 1988. As the first surgical modality, we performed scleral buckling in 82%, vitreous surgery in 9% and pneumatic retinopexy in 9%. Vitreous surgery was performed in 45% of 34 eyes which required a second surgery. At the time of discharge, the retina was reattached in 100% of eyes treated by scleral buckling, in 87% treated by vitreous surgery and in 88% treated by pneumatic retinopexy. The overall success rate was 97%. The causes of failure in 6 eyes were macular hole, posteriorly located retinal breaks and prolifer-ative vitreoretinopathy (PVR). The current rate of success is higher than our results 5 and 10 years before by about 2%. The improvement is ascribed to more prevalent use of vitreous surgery.